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Protect and survive

By Alan Stone

LIZ’S husband works in a factory in Johannesburg and only comes home to their village at weekends. She has overheard him bragging about what he gets up to in the city, and she knows about the risk of AIDS. But he refuses to wear a condom when they have sex. He says it’s like eating a sweet with the wrapper still on – and besides, how would they have children? Liz is in no position to put her foot down because she is financially dependent on her husband. The last time she tried to insist, he gave her a black eye.

Liz is not one person. Her story is an amalgam of those of a great many women in the developing world. Some 5 million people became infected with HIV last year, most of them living in Sub-Saharan Africa. For people like Liz, the steps most Westerners can take to avoid this deadly infection simply don’t exist.

Ultimately, the best weapon against AIDS will be a vaccine. Finding one is the focus of intense research around the world, but we shouldn’t hold our breath. It could be many years before even a partially effective vaccine is ready, and the virus’s daunting molecular defences mean it is likely to be a lot longer before a highly effective vaccine is licensed.

In the meantime, scientists in several countries are investigating a completely different approach to AIDS prevention. It may not be as glamorous as vaccine research – it’s a relatively low-tech, hopefully low-cost strategy involving readily available chemicals. But it might be the developing world’s best short-term hope for curtailing …